Nursing Your Older Baby and Weaning

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Baby-Led Weaning In cultures where unrestricted breastfeeding is the norm, weaning is a slow, baby-led process, geared to the baby's developmental needs. Among dozens of societies and cultures studied, breastfeeding extends into the third year, with the average age of weaning being around two and a half. The Bible contains references to weaning at age three, while the Koran calls for nursing until two years. In many cultures, breastfeeding continues to four years of age.

The gradual nature of the weaning process is captured by the expression "You never know when the last nursing has occurred." Toward the end of the transition, days or even weeks may elapse between nursings. Obviously, by this stage, the volume of milk is usually inconsequential. A nursing may last only a moment, as a youngster reassures himself of his mother's presence and love. What starts out as principally a method of feeding a newborn gradually evolves into principally a method of comforting and reassuring an increasingly independent toddler or preschooler. Baby-led weaning guarantees that the process is paced according to the child's unique dependency needs rather than society's expectations or the mother's preference. The chief advocate of child-led weaning in the United States is La Leche League. Bolstered by the support and example of like-minded peers, League members often nurse into their baby's third year or longer.

Late Nursing in the United States Certainly, contemporary American patterns of breastfeeding are extremely abbreviated by worldwide standards. In the United States, only about 25 percent of babies are still being breastfed at six months of age and about 15 percent at one year. The result is pervasive unfamiliarity with the image of the older breastfed baby and inadequate social supports for achieving the full, normal course of breastfeeding. All too often, what is uncommon translates into what is unacceptable. Instead of commending those few American women who manage to breastfeed the full course, we are quick to pass judgment. "Are you still nursing?" "Don't you think she's too old for that?"

A number of years ago, a new intern at a teaching hospital was performing a two-year checkup on a little boy when the anxious toddler became upset, lifted his mother's blouse, and petitioned, "Nursy, nursy." The stunned intern had not even considered the possibility of breastfeeding at this age, and it never would have occurred to him to even ask about it. Now he wondered whether the child was developmentally appropriate. He made an excuse to slip out of the exam room so he could ask the attending physician in the clinic whether breastfeeding at this late age was normal and what he should do about it.

This encounter prompted the faculty member to schedule a teaching conference to discuss late nursing, and I was invited to serve as a consultant at the seminar. After hearing the brief case presentation, I decided to pose a few more questions before making my comments. "How often does the youngster nurse?" I inquired. After a brief pause, the puzzled intern hesitantly replied, "I suppose with his meals."

This story serves as a reminder of how ill-informed and unfamiliar our society is about late nursing. Few Americans have any appreciation for the full natural course of breastfeeding and the way a baby moves from depending on the breast as the sole source of food to relying on the breast for comfort and reassurance. The same intern who doubted the normalcy of a two-year-old requesting to nurse would have been unaffected if a three-year-old asked for his pacifier or began sucking his thumb.

It's little wonder that many American women resort to "closet nursing" their older babies to avoid incurring the hostile comments of an uninformed public. Some have their toddlers use code words for nursing to avoid exposing their secret, such as the woman who taught her twenty-month-old to announce, "I want a snack," when she wished to nurse. Intuitive toddlers soon learn not to ask for "milky" in certain settings, but to save their request until they arrive home. Not only is late nursing uncommon, but when it does occur, it is largely hidden from public view.

Unfortunately, the tendency for late nursing to be masked in the United States only serves to perpetuate the problem of lack of familiarity with breastfeeding older babies. Rather than succumbing to societal pressure to disguise the practice, the relatively few women who manage to achieve the full natural course of breastfeeding should be encouraged to talk about their experience with confidence. Publicizing the normalcy of late nursing is the only way to make Americans more comfortable with the image of the older nursing baby. Rather than hiding it, we need to implement de-sensitization strategies to increase Americans' exposure to late nursing.

Several years ago, I observed one such desensitization opportunity when I had the privilege of being a guest on the Leeza Show. The entire hour was devoted to various aspects of breastfeeding. Early in the show, a woman guest who was breastfeeding her newborn admitted that she had nursed her first son, Philip, until he was four years old. Philip, now seven, was seated in the audience next to his grandmother. He was a darling child-engaging, confident, and apparently quite normal. Leeza approached the youngster, mike in hand, and asked him if he remembered breastfeeding and what it was like. The boy, speaking softly and articulately, explained with great precision that breastfeeding was "warm . . . and sweet . . . and nice for babies." In this brief moment, Philip became an effective spokesperson for late nursing by demystifying and normalizing it.

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